Benefits of a Postoperative Hip Orthosis After Routine Arthroscopy of the Hip: A Retrospective Cohort Study

Dylan Wentzel; Jake Enos; Jason Smoak; Ian Goodman; Damon Mar; Bryan Vopat; Scott Mullen; John Paul Schroeppel

doi:10.1177/23259671231212503

Benefits of a Postoperative Hip Orthosis After Routine Arthroscopy of the Hip: A Retrospective Cohort Study

Orthop J Sports Med. 2023 Nov 22;11(11):23259671231212503. doi: 10.1177/23259671231212503. eCollection 2023 Nov.

Authors

Dylan Wentzel¹, Jake Enos¹, Jason Smoak¹, Ian Goodman¹, Damon Mar¹, Bryan Vopat¹, Scott Mullen¹, John Paul Schroeppel¹

Affiliation

¹ Department of Orthopedic Surgery and Sports Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.

Abstract

Background: No consensus currently exists among orthopaedic surgeons regarding the benefits of hip orthosis after routine hip arthroscopy.

Purpose: To compare patient-reported outcome measures (PROMs) and reoperation rates between patients who were braced versus those who were not braced after routine hip arthroscopy.

Study design: Cohort study; Level of evidence, 3.

Methods: A retrospective review was conducted of 193 patients who underwent hip arthroscopy for femoroacetabular impingement (FAI) from January 1, 2018, to December 31, 2021, by 2 orthopedic surgeons at a single institution. Patients before July 1, 2019, were immobilized in a hip orthosis after hip arthroscopy (braced group; n = 101), whereas those after July 1, 2019, were not (nonbraced group; n = 92). Baseline PROMs (visual analog scale for pain, modified Harris Hip Score, Single Assessment Numeric Evaluation, and Veterans Rand 12-Item Health Survey [VR-12] Physical Component Summary and Mental Component Summary) were obtained for all patients and were repeated postoperatively at 2 weeks, 4 weeks, 3 months, 6 months, 1 year, and 2 years. The study groups were compared to evaluate differences in PROMs over time and 2-year postoperative reoperation rates. Group comparisons were also stratified by patient sex.

Results: There were no significant differences on any PROM between the braced and nonbraced cohorts at any timepoint. There were also no significant group differences in reoperation rates, with 8 braced patients (7.9%) undergoing reoperation and 1 nonbraced patient (2.3%) undergoing reoperation (P = .208). In the sex-stratified analyses, nonbraced male patients had significantly higher VAS pain and lower VR-12 Mental Component Summary scores at 6 months postoperatively compared with braced male patients (P = .043 and .026, respectively).

Conclusion: The study findings suggested that the use of an orthosis after routine hip arthroscopy for FAI does not improve patient-reported outcomes or negatively affect the 2-year reoperation rate. Postoperative bracing increases perioperative cost, and by foregoing routine bracing, patients may avoid the morbidity associated with wearing a brace for a prolonged period.

Keywords: clinical assessment/grading scales; hip arthroscopy; hip femoroacetabular impingement; physical therapy/rehabilitation.